Information
-
Document No.
-
Quarterly 1 Checklist
-
Client / Site
-
Conducted on
-
Prepared by Lynn Young
-
Location
-
Personnel
Cleanliness and Neatness
-
Are shelves dust free and neat?
-
Is the carpet free of debris and vacuumed on a regular basis?
-
Are the countertops clutter free?
-
Are the outside walls clean and repaired?
-
Is the filling bench free of clutter?
-
Is the consultation area clean and professional looking?
-
Is the office organized?
-
Is the storeroom organized?
Facility
-
Are the hours of operation posted at drop off, pick up and drive through?
-
Are current licenses and registrations posted in readily visible area for the public?
-
Pharmacy License
-
DEA Registration Certificates
-
Pharmacist Licenses
-
Pharmacy Technician Licenses
-
Pharmacy Technician Certificates
-
Certificates in readily visible area for pubic
-
Combat Methamphetamine Epidemic Act Certificate
-
American Board for Certification DME accreditation
-
Notices in readily visible area for public
-
Medicare Prescription Drug Coverage and Your Rights
-
Medicare DMEPOS Supplies Standards
-
Participation in PMP of state pharmacy is located in or adjoining state
-
FDA-approved Generic Substituion
-
Refrigerator and freezer (Log form MDH IC# 141-2233 on file for 3 years)
-
Electronically monitored 24 hours per day
-
Temperatures documented twice daily (35-46 degrees) at open and close
-
Person checking temperatures initials in min/max field
-
No food or beverage kept inside pharmaceutical refrigerator or freezer or vice versa
-
Fire escape plan posted near exit of pharmacy
-
Map of store's layout including pharmacy's location
-
Primary escape route
-
Fire drill conducted at least once per year and logged
-
Alternate escape route
-
Location of designated meeting point outside of store
Goals
-
Is pharmacy meeting their labor management goal?
-
Is the pharmacy meeting their flu vaccine goal?
-
Is the pharmacy meeting their other vaccine goal?
-
Does the pharmacy have their staff meeting planned?
-
Has the pharmacy planned their community outreach event?
-
Is the pharmacy on track to complete their Mirixa goal?
-
Is the pharmacy on track to meet their Outcomes CMR goal?
-
Is the pharmacy on track to meet their NER % in Outcomes?
Misc
-
Is the pharmacy using the Medicare stamp correctly?
-
Is the pharmacy submitting Navitus claims?
-
Is a pharmacy person attending the weekly manager's call?
-
Is the pharmacy MTM lead participating in the monthly MTM calls?
-
Is the Weekly Dashboard posted?
-
Is the Weekly Dashboard up to date?
-
Is the Weekly Pharmacy recap posted?
